gms | German Medical Science

79. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

30.04. - 04.05.2008, Bonn

Juvenile Laryngeal Papillomatosis Treatment trial with Gardasil®

Meeting Abstract

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  • corresponding author Andreas Müller - Klinik für HNO-Heilkunde/Plastische Operationen, SRH Waldklinikum Gera, Gera, Germany
  • author Gerhard Förster - Klinik für HNO-Heilkunde/Plastische Operationen, SRH Waldklinikum Gera, Gera, Germany
  • author Carsten Boltze - Institut für Pathologie, SRH Waldklinikum Gera, Gera, Germany
  • author Jörg Seidel - Klinik für Pädiatrie, SRH Waldklinikum Gera, Gera, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 79th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Bonn, 30.04.-04.05.2008. Düsseldorf, Köln: German Medical Science; 2008. Doc08hno41

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/hno2008/08hno41.shtml

Veröffentlicht: 8. Juli 2008

© 2008 Müller et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

In aggressive forms of juvenile laryngeal papillomatosis permanent voice and breathing impairments are almost inevitable due to the high number of necessary papilloma debulking surgeries. Various adjuvant therapies such as immune stimulation with Interferon alpha, local application of Cidofovir, photodynamic therapy or even Mumps vaccination have been tried to lower the frequency of recurrences.

In 2006 the quadrivalent vaccine Gardasil against HPV types 6, 11, 16 and 18 became available. In Gynecology this raised new hopes to prevent the majority of cervical carcinomas in future. The vaccine is generally well tolerated. Its safety was questioned recently because of two unclear deaths in the USA (after two million vaccinations). This is observed by the FDA.

In an individual healing trial between January and August 2007 a two year old boy with rapidly recurring HPV 6 and 11-associated laryngeal papillomatosis was vaccinated with Gardasil. There were no complications. HPV in situ hybridisation in a biopsy of a small recurrence could not reveal any remaining virus copies. The clinical course improved considerably. If a complete remission has been achieved has to be shown over time.

Figure 1 [Fig. 1], Figure 2 [Fig. 2], Table 1 [Tab. 1]

Although preventive vaccinations of future mothers may reduce the number of juvenile laryngeal papillomatosis we still need a better treatment for our symptomatic patients. Vaccinations with Gardasil are unlikely to cure manifest HPV infections. However virus-neutralising antibodies may suffice to facilitate an earlier remission of disease. A multicentric trial should analyse the risk-benefit potential of Gardasil.


References

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Tanne JH. Questions over human papillomavirus vaccine in the US and Australia. BMJ 2007;34:1182-3.
2.
Ruparelia S, Unger ER, Nisenbaum R, Derkay CS, Reeves WC. Predictors of remission in juvenile-onset recurrent respiratory papillomatosis. Arch Otolaryngol Head Neck Surg. 2003;129:1275-8.
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Gerein V, Rastorguev E, Gerein J, Jecker P, Pfister H. Use of interferon-alpha in recurrent respiratory papillomatosis: 20-year follow-up. Ann Otol Rhinol Laryngol. 2005;114:463-71.